Deck 14: Patient Billing and Collections

Question 1

How would a collections specialist document the following results? Try out your note-taking skills:
A. Telephoned residence and talked to the patient. He promised to pay by the end of the week and said he did not know the bill was unpaid.
B. Telephoned business, but there was no answer.
C. Telephoned residence and talked to patient. She said that she was no longer employed and refused to pay. Educated the patient that she needed to pay by the end of the month, but the patient hung up the phone.

Answer 1

(Note that answers may vary; point is for students to try notetaking.)
1. TR, PTP, EOW, DNK
2. TB, NA
3. TR, NLE, RP, EDU, EOM, HU

Question 2

Define these abbreviations.
Select the answer choice that best completes the statement or answers the question.
FCRA

Answer 2

FCRA - Fair Credit Reporting Act

Question 3

A patient owes $1,200 to the physician for a surgical procedure. Based on the payment schedule shown under Designing Payment Plans on the previous page, what monthly payment is the collections specialist likely to set up?

Answer 3

A payment plan for six months at $200 a month is likely.

Question 4

Define these abbreviations.
Select the answer choice that best completes the statement or answers the question.
ECOA

Question 5

1. Which of the following collection agencies would be the best choice to represent a practice based on financial statistics? Why?
Company A: Collection rate of 30 percent, charges 50 percent of the funds it collects.
Company B: Collection rate of 20 percent, charges 30 percent of the funds it collects.
( Hint: Work out the results based on $100.)
2. Assume that the practice has sent $10,000 worth of unpaid balances to Company B. How much money would the practice expect to receive based on the listed percentages?

Question 6

The following patient bill has been in collections and is going to be written off:
A. What amount has previously been written off as an adjustment due to the payer's allowed charge?
B. What amount must now be deemed bad debt?

Question 7

In your opinion, how will the ongoing transition to electronic health records affect record retention?

Question 8

Select the answer choice that best completes the statement or answers the question.
When talking with someone other than the patient about an overdue bill, collections specialists will

A) reveal the purpose of the phone call
B) mislead the person they are talking with
C) be unprofessional
D) not discuss the patient's debt

Question 9

Select the answer choice that best completes the statement or answers the question.
The day sheet produced by the practice management program shows

A) what each patient owes the practice as of that date
B) what each payer owes the practice as of that date
C) the payments and charges that occurred on that date
D) the overdue accounts on that date

Question 10

Select the answer choice that best completes the statement or answers the question.
During collections, most practices use

A) letters and calls
B) audit reports and tax returns
C) e-mail messages and faxes
D) local police and state police

Question 11

Select the answer choice that best completes the statement or answers the question.
Credit bureaus keep records about a patient's

A) medical history
B) credit information
C) disposable income
D) salary

Question 12

Calculating Insurance Math
A. Alan Lund is responsible for his medical bills and for those of his daughter, Alana, and he receives a guarantor statement. Complete the AMT DUE column by adding each charge to the previous total to find the running total. What amount is due for Alan, and what amount for Alana? What total amount is due on the October statement?
B. Gail Ferrar's statement is shown below. She is responsible for a 20 percent coinsurance.
Calculate the total amount due.

Question 13

Select the answer choice that best completes the statement or answers the question.
Collection calls are regulated by the guidelines set by

A) FCRA
B) FACTA
C) HIPAA
D) FDCPA

Question 14

Match the key terms with their definitions.

Question 15

Select the answer choice that best completes the statement or answers the question.
Accounts might be considered uncollectible when a patient

A) files for bankruptcy
B) directs phone calls to an attorney
C) needs a payment plan
D) has not responded to the first bill

Question 16

Study Figures 14.1 and 14.2 (pages 454-455), and then answer the following questions:
FIGURE 14.1 Example of a Financial Policy
FIGURE 14.2 Patient Payment Procedures
1. Who is responsible for any copayments, and when must they be paid?
2. What is a self-pay patient's financial responsibility for the initial visit? Under what circumstances can a self-pay patient be billed after the visit?
3. Whose job is it to explain the situation to patients when their insurance does not cover planned services?

Question 17

Select the answer choice that best completes the statement or answers the question.
Skip tracing increases the practice's chances of

A) avoiding embezzlement
B) locating a patient with an overdue bill
C) following FDCPA guidelines
D) successfully using the patient aging report

Question 18

Preparing Insurance Communications
Andrea Martini owes $400 to Valley Associates, PC for her son Ben's visit last month. Her account number is RR109. Ben is a dependent on her insurance, Amerigo Health Plan, which has paid its portion on the account. The account is at more than thirty days past due. Draft a collection letter requesting payment.

Question 19

Select the answer choice that best completes the statement or answers the question.
The practice will need to pay patient refunds if it has

A) received a payment from only a third-party payer
B) miscalculated its accounts receivable
C) overcharged the patient for a service
D) used information from a credit bureau

Question 20

Examine the patient statement in Figure 14.3c. Research the meaning of procedure code 99396. Based on the ages it covers, what is Karen's age range? Is she a new patient of the practice? What percentage of the charges does her insurance pay?
FIGURE 14.3c Patient Statement

Question 21

Select the answer choice that best completes the statement or answers the question.
The patient aging report is used to

A) enter payments in the patient billing system
B) enter write-offs to a patient's account
C) track overdue claims from payers
D) collect overdue accounts from patients

Question 22

In Figure 14.4, what is the name of the patient? The guarantor?
FIGURE 14.4 Example of Guarantor Billing

Question 23

Select the answer choice that best completes the statement or answers the question.
Bad debt is defined as

A) payer refunds
B) patient refunds
C) uncollectible A/R
D) collectible A/R

Question 24

1. Patient statements may be prepared using a spreadsheet format. The AMT DUE column is a running total; that is, the charge for each service line is added to the previous AMT DUE figure. The total due on the statement can be cross-checked by comparing the AMT DUE in the last box with the total of all CHARGES. These amounts should be the same. For example:
A. If for the 10/12/2018 charges, the patient made a payment of $50 and the third-party payer paid $20, what balance would be due?
B. What balance would be due if the patient and payer made these payments but the previous statement showed a $235 balance?
2. Because of the nature of the contact between collections specialists and patients, phone calls can sometimes be difficult, and collections specialists may need to involve their managers. In your opinion, should all patient requests to speak with a manager be honored?

Question 25

Define these abbreviations.
Select the answer choice that best completes the statement or answers the question.
FACTA